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General NPI Number Information
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NPI Number | 1336913722
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Entity Type | Organization
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Legal Business Name | GANJI & GANJI DDS CORPORATION
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Dates
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Enumeration Date | 11/07/2023
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Last Update Date | 11/07/2023
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Provider Practice Location Address
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Address Line | 2704 DEL AMO BLVD
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City | LAKEWOOD
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State | CA
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Zip | 90712-2902
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Country | US
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Telephone | 562-423-1441
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Fax | 562-432-1441
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Provider Business Mailing Address
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Address Line | 2704 DEL AMO BLVD
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City | LAKEWOOD
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State | CA
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Zip | 90712-2902
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Country | US
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Telephone | 562-423-1441
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DAVID GANJI
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Credential | DMD
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Telephone | 818-439-9954
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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